Dipeptidyl peptidase 4 (DPP-4) -inhibitors used for type 2 diabetes mellitus (DM) have been associated with significantly increased risk for bullous pemphigoid (BP). The purpose of the present study was to investigate the association of other DM drugs and the risk of BP in large national register data. We conducted a case-control study of 5079 BP patients aged over 40 years (mean age 77.6 years) and 19663 matched controls with basal cell carcinoma. Data on diagnoses and purchased reimbursed drugs were obtained from Finnish national registers. Associations between DM drug usage and BP were evaluated using a conditional logistic regression model. After adjusting with several neurological diseases, DM and aldosterone antagonists, anticholinergics, antipsychotics and dopaminergic drugs, only DPP-4 inhibitors in monotherapy or as combination regimens were associated with the increased BP risk. Vildagliptin and linagliptin were associated with the highest risk for BP in monotherapy (Adjusted Odds Ratios 4.50 [95% Confidence Interval (CI) 2.96 - 6.83] and 3.20 [95% CI 2.32 - 4.42], respectively) as well as in combination with metformin. Neither metformin monotherapy, sulfonylureas, sodium-glucose cotransporter 2 (SGLT2) inhibitors, glucagon-like peptide-1 (GLP-1) analogues nor thiazolidinediones were associated with increased risk for BP. The present study strengthens the view of DPP-4 inhibitors being the most evident risk factor for BP among DM drugs. Also, it offers novel data showing GLP-1 analogues and SGLT2 inhibitors not being associated with increased risk of BP.

ESDR039 - Glucagon-like peptide-1 analogues and sodium-glucose co-transporter-2 inhibitors do not increase risk of bullous pemphigoid

50th Annual Meeting of the European Society for Dermatological Research. VIRTUAL MEETING